Zika Virus in Latin America and the Caribbean: U.S. Policy Considerations

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Congress is debating how to respond to an ongoing outbreak of Zika virus, a mosquito-borne illness that has no treatment or vaccine and can cause microcephaly—a severe birth defect—and other neurological complications. As of June 16, 2016, 60 countries and territories had reported mosquito-borne transmission of the virus, 39 of which are in Latin America and the Caribbean and are reporting cases of Zika for the first time. Brazil, which has registered the most confirmed cases of Zika in Latin America, will host the summer Olympics in August 2016. Scientists expect that travel destinations in the Caribbean will see more cases as the summer’s warm, rainy season continues. More than 750 U.S. citizens, including pregnant women, have become infected through either travel or sexual transmission.

Frequent business and tourist travel, combined with the close proximity and similar climates of Latin America and the southern United States, means that mosquito-borne Zika infections are likely in the United States. Zika is primarily spread by Aedes mosquitoes—primarily Aedes aegypti but also Aedes albopictus, the latter of which is present in a majority of U.S. states. Local (or mosquito-borne) transmission has not yet occurred in the continental United States but is occurring in Puerto Rico and the U.S. Virgin Islands.

On February 8, 2016, the Obama Administration submitted an emergency request for almost $1.9 billion in supplemental funding to respond to the Zika outbreak, including $526 million for international efforts. On April 6, 2016, the Administration announced that it would reprogram $589 million in unobligated funds, including $510 million in Ebola supplemental funds, for efforts to address the Zika outbreak. The U.S. Agency for International Development (USAID) is reprogramming $215 million of that funding—including a $78 million transfer to the U.S. Centers for Disease Control and Prevention (CDC)—for international efforts. In mid-May 2016, both the House and the Senate passed supplemental appropriations measures for Zika response. The House bill, H.R. 5243, would provide $622.1 million in Zika funding and rescind an equal amount of budget authority. The Senate measure (S.Amdt. 3900 to H.R. 2577, the combined FY2017 Military Construction-Veterans Affairs and Transportation-Housing and Urban Development appropriations bills) would provide $1.1 billion in Zika response funding without rescissions. On June 23, 2016, the House agreed to a conference agreement (see H.Rept. 114-640 ) that would provide $1.1 billion for Zika response, including $175.1 million for State Department and USAID activities. On June 28, 2016, the Senate voted not to invoke cloture on the conference agreement.

The number of people in the Western Hemisphere affected by Zika is unknown, but as many as 4 million people may be at risk of infection in 2016, and nearly all countries in Latin America and the Caribbean have recorded cases of the virus. Zika responses in the region have been led by Brazil and Colombia, multilateral organizations such as the World Health Organization (WHO)/Pan American Health Organization (PAHO), and the U.S. government. Health experts have expressed concerns about the capacity of health systems—particularly in Central America and the Caribbean—to prevent, diagnose, and care for Zika cases and associated complications, particularly among pregnant women. Related issues of interest to Congress include how to balance support for U.S. initiatives and multilateral approaches, the proper scope and components of U.S. health assistance to the region, and funding for pandemic preparedness and research on neglected tropical illnesses in Latin America.

This report focuses on the Latin American dimensions of the Zika virus. […]

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